A Year in the Life of the Largest Contact Tracing Program in the United States

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Every New Yorker has their own recollections from the days following March 1, 2020 – the day officials confirmed the city’s first case of COVID-19. Empty streets and sidewalks. Ambulance sirens punctuating the eerie silence. Mobile morgues set up outside hospitals. During those terrifying days, I developed a fixation on daily briefings. One of them changed my life – and the trajectory of the virus in New York City.

On April 22, 2020, New York State Governor Andrew Cuomo and former New York City Mayor Mike Bloomberg announced the creation of the largest contact tracing program in our nation’s history. Six weeks later, the NYC Test & Trace Corps, part of the New York City Health and Hospitals system, launched with a team of 2,500 contact tracers. I was one of them. That army has grown to 4,000 strong and includes several types of contact tracers: case investigators, monitors and community engagement specialists.

“I knew for us to succeed, we needed to be a program of New Yorkers helping other New Yorkers,” Dr. Ted Long, executive director of Test & Trace, said. “This new program would guarantee we would never go back to what I experienced in the early months of 2020.”

On March 29, 2020, New York City’s hospital admissions peaked with an average of 1,566 admissions per day. “My most scared moment was when I thought to myself, ‘What if we don’t succeed here? What would happen?’” Long remembered. “And I realized for the first time: Failure was truly not an option.”

“Launching a program of this size in such a short period of time, it was definitely, in my professional life, the hardest thing I’ve done,” Dr. Neil Vora, the former director of Trace, said. His previous work as an epidemic intelligence officer for the Centers for Disease Control and Prevention involved tracing infectious diseases including Ebola, HIV and SARS. He now had three weeks to build the COVID-19 trace program for a June 1 launch.

“People are dying, people are getting sick, businesses were being ruined,” Vora said. “We didn’t have time to wait for the perfect contact tracing system, we just had to get something launched.”

And they did.

The Launch

June arrived with New Yorkers riding out the bottom half of the first wave.

The front line of the battle against COVID-19 in New York City relied on case investigators like Danielle Martinetti. She reaches out to those recently diagnosed with COVID-19 and attempts to gather information on their close contacts.

“Sure, there are some New Yorkers who are yelling at you, ‘I’m not telling you anything and don’t ever call me again,’ but there are so many good things, and if you have an ounce of empathy, you can carry through and get the job done,” Martinetti said.

Many tracers felt compelled to do just that following their own COVID-19 tragedies. In April 2020, Maria Fischer’s husband learned his uncle had contracted the virus. He was hospitalized, put on a ventilator and died – joining hundreds of others who succumbed to a similar fate.

“We couldn’t visit him when he was sick or even attend his funeral. This was surreal,” Fisher said. “I knew I had to find a way to help.”

Fischer landed at Test & Trace as a contact monitor, just like me. Monitors call cases and contacts throughout their isolation or quarantine period to conduct wellness checks and assess needs for the city’s free resources. The calls also connect New Yorkers with a battalion of 400 resource navigators who arrange everything from food deliveries to dog walking services.

“It’s great, because honestly, when you’re sick, or if a family member is sick, you shouldn’t have to worry about anything else but getting better,” Fischer said.

When tracers fail to reach clients by phone, community engagement specialists like Akanksha Anand mask up and travel to their doorstep. “In those initial months, it was frightening to be out there,” Anand, 25, recalled. “You don’t know where to touch, you don’t know where to breathe.”
Between July 26 and August 8, 2020, 78 percent of case intakes were completed, surpassing the program’s goal of 75 percent. Former Trace Director Neil Vora explained this target was based on prior scientific experience with contact tracing for other diseases.

“All of our protocols and what we do are based on the science, but the art of contact tracing is establishing that human-to-human connection,” Vora said.

By July, that connection helped New Yorkers earn what Long calls a “well-earned reprieve.”

“In a city of 8.3 million people, to have 200 to 300 cases on some days, you can’t do much better than that,” Long said. “New York City had a better control and suppression of the virus than almost any other place in the country.”

But by the end of September, the seven-day case average had once again exceeded 500. By the end of October, it surpassed 800.

“The two questions that kept me up at night at that point were: ‘Can we hold the line?’ and ‘Can we diminish how bad it gets?’” Long said.

The Second Wave

The city’s case volume increased by more than 2000 percent between September 2020 and January 2021, with a jump in daily cases from 235 to 5,800. I was averaging 30 calls a day. It took a toll on my vocal cords, my lower back and my mental health.

“I remember waking up one morning and just taking a really deep sigh and thinking, ‘Where am I going to find the strength to do this today and continue to do this job?’” Martinetti said.

Meanwhile, Trace’s community engagement specialists clocked more door-to-door miles and staffed pop-up sites.
“Compared to the five largest states, we had the lowest peak in terms of daily new cases. The credit for that is completely to New Yorkers doing their part – wearing masks, getting tested – and you and everyone on the phones as contact tracers,” Long explained.

Vora agrees. He credits Test & Trace for a second-wave death rate 10 times lower than that of the first wave.
”We saw too many New Yorkers die in their homes in the first wave, and Trace wasn’t set up back then. But within the second wave, you were all calling these cases and telling them, ‘If you experience emergency warning signs, you need to call 911 or get to the emergency department,’” Vora said. “And you were also recommending contacts get tested, so people were getting into care early if they did indeed test positive.”

The Turnaround

On December 14, 2020, the first vaccine was administered in the United States – and it happened in Queens. Weeks later, a nearly empty Times Square joined the rest of the world in welcoming 2021. Despite a cold and dreary winter, spring finally arrived.

On that first day of the new season, the city reported 2910 new COVID cases; fewer than 55 deaths and just 262 hospitalizations. As more New Yorkers get vaccinated, the numbers continue to improve.

Now the calls are more about, ‘How can we get you out of your homes? How are you being protected and able to go back to normal?” said Supervisor Jason Rubenstein.

“When I look back over the whole year, the main thought I have is what incredible work we did together, and we earned this being the summer where I am going to take my kids outside every single day,” Long said.

Looking Forward

Only one thing is certain: COVID-19 will not disappear. Long believes vaccines are the solution we have been waiting for, but he does see the eventual need for boosters.

Unless things change globally, Vora believes the next pandemic is 10 to 15 years away. To work on preventing that, he left Test & Trace in March 2021 for a new role at Conservation International.

“Every outbreak I have ever responded to with the exception of measles was the result of a spillover from animals into people,” Vora said. “And this is going to keep happening unless we look into why, and it comes back to: We’re cutting down rainforests, we’re trafficking wildlife and we’re raising domestic animals in unsafe ways.”

As Test & Trace begins its second year, we can be New York Proud knowing an army of 4,000 and cooperation from the neighbors we called upon helped us get here. Despite our differences, we came together to defeat an enemy. Just like we did after 9/11. Just like we did after Superstorm Sandy. Just like we will always do when anything threatens this incomparable place we call home.

I’ve worked as a broadcast journalist, corporate video producer and TV host. Just before the pandemic hit, I was ready to make a major career change to become a personal trainer with an interest in senior health and wellness. Then the gyms closed. Then I took an online Johns Hopkins contact tracing course and became a part of NYC Test & Trace.

—Laura DeAngelis,
1991 St. Mary’s High School graduate

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